Abstract
Polycystic ovary syndrome (PCOS) is the most common endocrine disorder among premenopausal women. PCOS may have reproductive, metabolic, cardiovascular, and psychological implications. Vitamin D deficit is often encountered in PCOS women and may contribute to the pathophysiology of this disorder. As of the key role of vitamin D in bone and mineral metabolism, and because the vitamin D status appears to be closely linked with the PCOS manifestations including insulin resistance, obesity, ovulatory and menstrual irregularities, oxidative stress and PTH elevation, hypovitaminosis D may directly and indirectly via the different facets of PCOS impair bone health in these women. Although limited data are available on life-long fracture risk in women with PCOS, the importance of preserving bone health in youth and adults to prevent osteoporosis and related fractures is also recognized in PCOS women. Evidence of the association between vitamin D and the clinical hallmarks of PCOS are summarized and discussed. Vitamin D arises as a cornerstone in women with PCOS and contributes to the pathophysiological link between PCOS and bone metabolism.
Highlights
Polycystic ovary syndrome (PCOS) is a heterogeneous endocrine disorder affecting up to 20% of premenopausal women, possibly making this syndrome the most common endocrine and metabolic disorder in women of reproductive age
PCOS is defined in accordance with the Rotterdam criteria (at least two of the following criteria: (1) irregular/no ovulation; (2) clinical/biochemical hyperandrogenemia, and (3) polycystic ovaries [1] or the National Institutes of Health (NIH) criteria or the Androgen Excess and PCOS Society (AE-PCOS) criteria [4]
A poor vitamin D status has been associated with the salient features of PCOS including insulin resistance (IR), ovulatory and menstrual irregularities, decreased pregnancy rate, hirsutism, hyperandrogenism, obesity, and elevated cardiovascular disease [6,7]
Summary
Polycystic ovary syndrome (PCOS) is a heterogeneous endocrine disorder affecting up to 20% of premenopausal women, possibly making this syndrome the most common endocrine and metabolic disorder in women of reproductive age. PCOS was first described in 1935 by Stein and Leventhal as the combination of hirsutism (a condition of male pattern terminal hair growth in women), amenorrhea, chronic anovulation and infertility, obesity, and enlarged cystic ovaries [1,2,3]. About 67–85% of women with PCOS show vitamin D deficiency [6]. A poor vitamin D status has been associated with the salient features of PCOS including insulin resistance (IR), ovulatory and menstrual irregularities, decreased pregnancy rate, hirsutism, hyperandrogenism, obesity, and elevated cardiovascular disease [6,7]. A poor vitamin D status has been consistently associated with an increased risk of fragility fractures in several clinical settings [8,9,10]
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